Back problem @ NSAID [non running related]

[Tristan]

Not sure if to post here this has to be running related or not. Assuming its ok...

First a little on what happened...

Back it September I took a bad fall down the steps to the basement. They are pressure treated wood and always slippery. It was also drizzling all day long and they were slick. I knew better but was in a hurry and completely forgot. When my feet hit the top step (I was going down) they shot out in front of me and I knew I was screwed. I was actually running when I hit the step (long story) so I had some momentum and freefell 1/2 or 2/3 the way down before hitting the steps with my back and rear. I hit both steps at the same time, one was across the center of my back and the other basically right on the seat of my pants. I also tore a good bit of skin off my left forearm and both hands and fingers and tore a couple nails on each hand, trying to grab the cinder block wall as I fell. I was a little stunned but only laid there for maybe 10 or 20 seconds and got up and moved around to make sure nothing was broken. Seemed to have full range of movement on everything, I was sore all over so at the time I couldnt pinpoint any particular soreness. But the worse was between my purple forearm and my neck which I had pulled my head up to avoid my head hitting a step, I had tensed my neck to hard, but didnt hit my head at all and the neck pain went away by a couple days.

Jumping ahead to now. I have had lower back pain since the incident. Nothing severe, only mild, but always there. Hasnt gone away for even one day, although some days I can barely feel it. The step that hit me in the back didnt seem to do much, but the one that nailed me in the glutes left a bruise for a few days and I think the shock traveled up to my spine a few inches. I hadnt taken any meds for it, I usually dont take any meds unless absolutely necessary. But I kept fearing that I messed up my back. I thought it should have got better by now. So just monday I went in to the doc and got an x-ray. He couldnt see or find anything wrong. Thats mainly all I was interested in but he was going to put me in PT and a 3 week prescription of naproxen.

I'm a little leery of taking that much naproxen when my back, although a little sore, is quite fine and doesnt effect me really at all. I can run, I can split wood with and axe and cary and stack it just fine. So far I have not gone to pick up the prescription. Should I? I'm also not sure about the PT... I live way out in the country and the doc prescribed me PT there on site wich is a 1hr drive. No way that will fly. However in conjunction with work its only an extra 15-20 min out of my way, so maybe 30-40 min total, but I dont really see myself doing this on a working day. I work 12hr shifts with an hour drive each way by the time I come home I am exhausted and my wife is usually still working and needs me to be there to watch our son. My MIL is a PT also, and this past weekend she had me do several things and nothing made a difference better or worse. I can try to continue doing the exercises myself though to see if anything changes over a longer term.

 

[Barefoot TJ]

That sounds like a terrible

That sounds like a terrible fall. Hope you get well soon.

 

[Dr. Gangemi_SockDoc]

I am against NSAIDs at any

I am against NSAIDs at any dose with the rare exception if someone is in a very traumatic injury and they need pain relief quickly. NSAIDs work by balancing prostaglandins in your body, and therefore if they "work" for you (relieve pain) then your prostaglandins are out of balance. This means your natural anti-inflammatory compounds, primarily fats, are out of balance - you have too many bad inflammatory ones, and not enough good, anti-inflammatory fats.

So since your injury is many months old, if you decided to take the NSAID (naproxen) and you felt better - well that would indicate your body is inflamed. Sure, that's obvious I realize but it shouldn't be inflamed, not this long after an injury. That would tell you your diet needs a fixin' and you need to cut down/out the vegetable fats (canola, corn, soy, safflower, peanut, etc) and increase the fish oil, perhaps flax, and coconut, eggs, avocados, and maybe even some butter fats. I see a tremendous improvement in people when they do this. Sometimes it takes a couple week for the fats to take effect, but once they do, not only is pain greatly reduced, but the person feels better overall - and any future injury heals so much faster. More on that here:

http://sock-doc.com/2011/03/dietary-danger-partially-hydrogenated-trans-fats/

Also, if you read the "GAGS" post I have on this site, you know that NSAIDs will deplete sulfur from your body, and that will hinder joint/tissue repair.

Now with the PT. I'm not a fan of PT, but then again I think most therapies out there are nothing special. So it's nothing personal against PTs, there are some really great ones, just as there are chiropractors, medical doctors, and podiatrists, and some really bad ones, also in all fields of health care. PTs tend to think that joint and muscle imbalances are corrected by strengthening the weak muscles by exercising them and relaxing the tight muscles by stretching them. It doesn't work (and for this I say never does it work - not even one time will this work - PTs can hate me), as I note in the "Stop Stretching!" post. Once the muscle imbalances are corrected, then I'm all for strengthening those muscles via functional movements as part of a rehab program - such as dynamic movements (running and walking included) - not isolating muscles as most therapists are taught. Other dynamic movements are those taught by MovNat (such as the bear crawl - that's a great one) and kettle bell exercises (hip swings and deadlifts are great for your low back/hip type of injury rehab). Proper instruction here is key, please note.

But before you get to the rehab you have to deal with the injury - so you hit it chemically/nutritionally as well as physically. This is what your MD knows - hence the naproxen (the chemical part) and the PT (the physical part). But I say change your diet - deal with the inflammation naturally and for the physical part you have to address those muscle imbalances. For that you're going to need some muscle work to fix those injured areas where you were injured, and unfortunately, since you've been walking/running/moving screwed up for several months, you've probably created more. Those need to be addressed - and the best ways are typically by working the trigger points out, but you may not be able to reach some of them, or even find some of them. So I'd suggest you find a good massage therapist, rolfer, chiropractor (who deals a lot with muscles) or yes, even a good PT who knows a lot about gait and muscle function and doesn't just want to stretch, ultrasound, and e-stim you.

 

[Tristan]

Thank you TJ!Dr G., Thank

Thank you TJ!

Dr G.,

Thank you for your time. Your articles are very informative and eye opening. I have read most of them, but also most of the info doesnt 'stick' after a while... I'll re read them again especially the ones you mention above.

For now, I wont take the NSAIDs (didnt want to anyhow), and try to focus on the fats. Since I read your article first a couple months ago I have focused on reducing veg fats and hydrogenated oils, one thing that is hard in particular is cutting out oil for cooking as most of my favorite marinades (mainly eat venison) primary ingredients are oils, mainly olive oil. I dont know how much oil actually get absorbed by the meat though, and I do almost exclusively grill instead of fry whenever possible but now when temps dip below freezing the grill becomes less appealing and I break out the cast iron inside.

Massage sounds good to me too! Well probably the message I need wont feel that good. Never had one before so not sure where to go other than looking up random things in the phonebook. I've tried rubbing and feeling around but like you say its hard to find the spot. When the doc asks where it hurt and my MIL too, I cant really even tell for sure. I can sort of feel it just sitting here, but when I rub around I dont seem to find anything that I can feel.

With the X-ray showing things ok, it is most probably muscle thats still the problem, right? The only thing that keeps bugging me in the back of my mind is that it doesnt seem to me like I should have a muscle problem in my lower back resulting from an impact in the hip... I could understand it if I was bent over lifting something... but this just doesnt seem to me to be consistant with an impact injury. I guess I am still worried that I screwed something up in my back thats not muslce related, but the x-ray did show normal I guess. The only explanation I have come up with is maybe I tensed it too much when I was falling. I did that with my neck -to avoid my head hitting I pulled it up hard (pretty much just a reflex) and I did avoid hitting my head. However my neck was severely stiff for a day, but was fine by a couple days.

 

[Dr. Gangemi_SockDoc]

Tristan, olive oil is fine

Tristan, olive oil is fine (that's an omega 9), you want to stay away from the omega 6 refined vege oils. Your primary cooking oils should be coconut oil and butter. Lard is good too if you can find a good organic source.

Yeah it's tough to find someone good. And you need someone who knows how the body is interconnected. Look for a rolfer, those are typically more specialized that massage therapists. Depends on their training though. I saw a soccer player yesterday whose hand injury wasn't healing up and I ended up treating a muscle in his rib cage (his serratus) and that fixed the hand pain he was having - 100% of it.

The muscles are always the problem, just sometimes more, sometimes less. Even in a fracture the muscles are involved. Actually a lot of a pain from a break can come from the ligaments and tendons attaching to the bone more than the break itself.

Don't fool yourself with Xrays. Just because something is clear doesn't mean all is good and even when it shows something is bad doesn't mean that's where the problem is. I can tell you countless stories (and I'm sure Dr. Klein can too) of MRIs showing major disc problems right where the person's exact pain is and the patients come to us after having the disc removed or decompressed and the pain is 0% better.

Likewise, don't think that because you have no pain in an area you are good to go. Sounds like you got some whiplash in the fall, and that neck strain could still be causing low back and hip problems.

 

[Tristan]

Never used coconut oil but I

Never used coconut oil but I know you have mentioned that a few places in your articles, I'll definately try to get some and try it out. I do use mainly olive oil but I guess I was concerned this was added before cooking, meaning the oil is heated up. And thought I read that it becomes bad for you if heated. I guess as a marinade though in the meat, it doesnt get that hot. Maybe in a stir fry pan it gets really hot though. My diet has gone to heck though for the hollidays, I'm not one who passes up any food, that would be rude right? lol. But what gets me is all the cookies and pies and dessert stuff that lasts for a few weeks.

 

[Dr. Gangemi_SockDoc]

Heat and light denature

Heat and light denature oils/fats - the more saturated they are, the more heat they can withstand. This is why coconut and butter are great for cooking - especially frying. I believe the "smoke point" of olive oil is 350-375. Okay to cook at low temps but better to add after cooking.

Of course oils such as grapeseed, corn, and soy are touted as great for cooking but that's because they're typically highly refined omega 6 polyunsaturated fats which, especially when combined with carbohydrates (like in desserts, breads) create a whole lot of inflammation.

 

[jmcadams]

Dr. Gangemi_SockDoc wrote:I

I am against NSAIDs at any dose with the rare exception if someone is in a very traumatic injury and they need pain relief quickly. NSAIDs work by balancing prostaglandins in your body, and therefore if they "work" for you (relieve pain) then your prostaglandins are out of balance. This means your natural anti-inflammatory compounds, primarily fats, are out of balance - you have too many bad inflammatory ones, and not enough good, anti-inflammatory fats.

So since your injury is many months old, if you decided to take the NSAID (naproxen) and you felt better - well that would indicate your body is inflamed. Sure, that's obvious I realize but it shouldn't be inflamed, not this long after an injury. That would tell you your diet needs a fixin' and you need to cut down/out the vegetable fats (canola, corn, soy, safflower, peanut, etc) and increase the fish oil, perhaps flax, and coconut, eggs, avocados, and maybe even some butter fats. I see a tremendous improvement in people when they do this. Sometimes it takes a couple week for the fats to take effect, but once they do, not only is pain greatly reduced, but the person feels better overall - and any future injury heals so much faster. More on that here:

http://sock-doc.com/2011/03/dietary-danger-partially-hydrogenated-trans-fats/

This is interesting. I have been having back/hip pain for about a month & ibuprofin helps a lot. I assume that would indicate inflamation. I try to stay away from the ibuprofin, but I take it when it gets bad. I take fish oil supplements, I never cook with vegetable/canola/corn/peanut oil, I eat eggs, and I very rarely eat fried foods. Anything else I can do?

 

[Dr. Gangemi_SockDoc]

Other things to do:Make

Other things to do:

Make "rarely eat fried foods" NEVER.

Use coconut oil and milk every day. More the better. Best oil in the world in my opinion.

Get all the grains out of your diet - especially wheat and oats, but also rice, potatoes, and corn. Follow the Paleo-Type diet I discuss on my sites.

Ditch beans/legumes too.

 

[Barefoot TJ]

Geez, Dr. G., there's nothing

Geez, Dr. G., there's nothing left to eat! Hee.

 

[Tristan]

Dr. Gangemi_SockDoc

Get all the grains out of your diet - especially wheat and oats, but also rice, potatoes, and corn. Follow the Paleo-Type diet I discuss on my sites.

Was this specifically for jmcadams or are you recommending this for everyone? I'm struggling switching TO whole grains from processed stuff, but I couldnt see going without any breads or cereals at all? And rice? Even brown or wild rices? Potatoes and corn will always be a part of my diet since I can grow them myself, and at least the potatoes are one of the few things from the garden that I can store for winter. I can't see excluding these things for long term.

 

[jmcadams]

Dr. Gangemi_SockDoc

Other things to do:

Make "rarely eat fried foods" NEVER.

Use coconut oil and milk every day. More the better. Best oil in the world in my opinion.

Get all the grains out of your diet - especially wheat and oats, but also rice, potatoes, and corn. Follow the Paleo-Type diet I discuss on my sites.

Ditch beans/legumes too.

And now you take away my beans.... Holy Hell! ;-)



Just kidding. Thanks for the advice. I've recently started getting into crossfit & a lot of the crossfitters are into the Paleo diet. I'll check it out. Thanks again.